Questions of case 2: - educational case of cytology

1)    What is the most possible diagnosis?

2)   Do you need the additional clinical information and anccessary studies for your final diagnosis?

3)   Which molecular testing is needed to make the definitive dignosis?

A.              a)  t(15;19)(q14;p13.1) NMC-NUT

B.              b)  PLAG1 gene alterations

C.              c)  t(6;9)(q22-23;p23-24) MYB-NFIB

D.              d)  t(11;19)(q12;p13) MECT1-MAML2

 

Enjoy and have fun!

 Interesting case. Thank Dr. Yang for sharing the case

Immunohistochemical studies are shown at Figure 1. Base on the immuno data, what is the most appropriate diagnosis? 

What is the most possible diagnosis?

DDx: adenoid cystic carcinoma, epithelial-myoepithelial carcinoma, pleomorphic adenoma.

Do you need the additional clinical information and anccessary studies for your final diagnosis?

Yes. Such as what is the previous reason for surgery?

IHC showed epithelial component is positive for panK and weakly pos. for cKit. Myoepithelial cells are pos. for panK, p63, SMA and CK5/6.

Which molecular testing is needed to make the definitive dignosis?

 The final Diagnosis is "adenoid cystic carcinoma, METASTATIC".  It is a rare and very challenging case. Thanks -- HY